This past weekend I had the pleasure of participating in the TIR (Texas Independence Relay). TIR is a 203.3 mile foot race between Gonzales and San Jacinto, Texas; two important towns in the state’s journey to independence from Mexico in 1836. The race is a relay composed of 40 legs which range from roughly 3 to 9 miles in length. The race begins Saturday morning with staggered starts designed to insure all 140 teams reach the San Jacinto monument on Sunday afternoon. The typical team ranges in size from 8 to a maximum of 12 runners although there were some smaller teams this year including a solo runner attempting to complete the entire distance.
Our team, “Most Likely to Secede,” was composed of five women and six men in addition to our two drivers. Few of us knew everyone on the team at the start, but 29 hours later at the finish we were all on more than a first-name basis. The experiences we shared and stories we told are things I will not soon forget.
If you are still reading you are probably wondering how the TIR made it into this blog about health IT and nephrology. Part of the credit goes to the leg I ran at 2 a.m. Sunday morning. Under a moonless sky on a country road in Texas, it occurred to me that competing in the Texas Independence Relay has quite a bit in common with the challenge of demonstrating meaningful use. Perhaps the combination of sleep deprivation, physical endurance and the surreal nature of the experience under the stars that night affected my judgment, but here are some of my take ways.
The first and most important similarity is the value of teamwork. Running 203 miles across Texas and demonstrating meaningful use can both be accomplished alone, but everyone would agree each is substantially easier to achieve with the appropriate team in place. Our team captain Bert filled the leadership role perfectly as requirements for a variety of duties necessary for our success were delegated responsibly. Those of you planning to demonstrate meaningful use will be well served to identify a champion or leader within your practice, someone who is willing to become familiar with the meaningful use framework and keep everyone within your practice on the same page.
Second, the Achilles heel of any relay revolves around the logistics at the point of hand-off. This relay had 40 legs which meant 39 times over the course of the race one of our two van drivers had to deliver the next runner to the exchange point in time for the arrival of the inbound runner. We witnessed several instances where other teams failed to execute this critical step. Sissy and Audrey performed admirably in this role for our team and without them our success would have been in jeopardy.
There were far too many contributions from our TIR team to mention them all, but here are a few:
• Carmen volunteered to organize foods and fluids. Distance runners reading this blog will recognize the vital importance of remaining fueled and hydrated. It can be very difficult to locate provisions at 4 a.m. on the back roads of Texas.
• Larry divided the 40 legs among our team members, conforming not only to race rules but also accommodating multiple requests regarding length and terrain.
• Sarah insured team camaraderie with her fantastic design and procurement of “Most Likely to Secede” t-shirts.
• Erik traveled all the way from Brooklyn, NY, bringing his blazing speed—without which we would have never cracked the 30-hour mark (and might still be out on the course).
Finally, one week before we started, one of our fastest runners had to withdraw due to injury. A challenge that could easily have created more than a simple speed bump for us was easily absorb with teamwork as we went from 12 to 11 runners.
Demonstrating meaningful use will require different things for different practices. Most of you will find your Sissy and Audrey, completing tasks which are integral to your success. Who is responsible for printing the clinical summary? Where do you record preferred language? Who is recording height?
Many will identify their Carmen and Larry, organizing the group’s efforts around the pivotal processes required for success. Who is monitoring the meaningful use dashboard? Who is making sure tasks are well matched with the skill sets that exist within your practice and its existing work flow?
Hopefully everyone demonstrating meaningful use will find their Sarah—someone to facilitate the spirit required to successfully reach the finish line. And many will find Erik—someone to lift the pace and serve as an example for the rest of the team.
There is one final similarity between TIR and meaningful use that became clear to me as we finished the relay. At the outset of these two “races” we tend to focus on the finish line whether it’s the San Jacinto monument in Houston or collecting a well deserved incentive from CMS. But, in truth, the journey itself is far more important. The experience of participating in TIR will be with me for many years to come. As you and your practice take the steps necessary to demonstrate meaningful use, you will begin a subtle shift towards integrating health information technology productively within the workflow of your practice. Each of these races has a finish line, but the impact of the journey will last well into the future.
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